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Semin Reprod Med 2011; 29(5): 436-445
DOI: 10.1055/s-0031-1287667
© Thieme Medical Publishers

An International Response to Questions about Terminologies, Investigation, and Management of Abnormal Uterine Bleeding: Use of an Electronic Audience Response System

Malcolm G. Munro1 , Michael Broder2 , Hilary O.D Critchley3 , Kristen Matteson4 , Rohana Haththotuwa5 , Ian S. Fraser6
  • 1Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, California
  • 2Partnership for Health Analytic Research, LLC, Beverly Hills, California
  • 3MRC Centre for Reproductive Health, The University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, United Kingdom
  • 4Division of Research, Department of Obstetrics and Gynecology, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
  • 5Ninewells CARE Mother & Baby Hospital, Colombo, Sri Lanka
  • 6Department of Obstetrics and Gynaecology, University of Sydney, Camperdown, Australia
Further Information

Publication History

Publication Date:
07 November 2011 (online)

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ABSTRACT

More than 600 registrants attended a two-hour interactive symposium on abnormal uterine bleeding (AUB) at the Federation of Gynecology and Obstetrics World Congress in Cape Town, October 2009. Nearly 250 of these participants answered multiple questions through an electronic audience responder system. The audience heard five structured presentations on clinically important and controversial aspects of AUB, including terminologies and definitions, classification of causes, mechanisms of AUB in the absence of structural lesions of the reproductive tract, the potential for a structured menstrual history, and management of heavy menstrual bleeding (HMB) in low-resource settings. Numerous demographic details were collected, and a total of 30 questions to the audience were interspersed through each of the presentations. The audience demonstrated great variation in the way the terms AUB, menorrhagia, and dysfunctional uterine bleeding (DUB) are used, and considerable majorities agreed that the terms menorrhagia and DUB should be abolished. AUB should be the overarching term to describe all symptomatic departures from normal menstruation or the menstrual cycle. HMB is a suitable replacement term for menorrhagia. DUB can be replaced by the three clinical entities comprising “nonstructural” causes of AUB. There was a high consistency across demographic subgroups in answers to most questions. Acute and chronic AUB were defined, and aspects of a classification system for causes of AUB and of a structured menstrual history were explored. Issues related to investigation and hormonal treatment of HMB in low-resource settings were explored by registrants from developing countries.

KEYWORDS

Abnormal uterine bleeding - terminologies - investigation - management - menorrhagia - FIGO classification

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Malcolm G MunroM.D. 

Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Kaiser Permanente, Southern California

4900 Sunset Boulevard, Station 3-B, Los Angeles, CA 90027

Email: mgmunro@ucla.edu; mgmunro@aol.com

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